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Review
. 2020 Jul-Sep;10(3):134-138.
doi: 10.4103/2045-9912.289462.

Rationale for ozone-therapy as an adjuvant therapy in COVID-19: a narrative review

Affiliations
Review

Rationale for ozone-therapy as an adjuvant therapy in COVID-19: a narrative review

Giovanni Tommaso Ranaldi et al. Med Gas Res. 2020 Jul-Sep.

Abstract

Coronavirus disease 2019 (COVID-19) is the respiratory disease caused by the novel severe acute respiratory syndrome-coronavirus-2 and is characterized by clinical manifestations ranging from mild, flu-like symptoms to severe respiratory insufficiency and multi-organ failure. Patients with more severe symptoms may require intensive care treatments and face a high mortality risk. Also, thrombotic complications such as pulmonary embolisms and disseminated intravascular coagulation are frequent in these patients. Indeed, COVID-19 is characterized by an abnormal inflammatory response resembling a cytokine storm, which is associated to endothelial dysfunction and microvascular complications. To date, no specific treatments are available for COVID-19 and its life-threatening complication. Immunomodulatory drugs, such as hydroxychloroquine and interleukin-6 inhibitors, as well as antithrombotic drugs such as heparin and low molecular weight heparin, are currently being administered with some benefit. Ozone therapy consists in the administration of a mixture of ozone and oxygen, called medical ozone, which has been used for over a century as an unconventional medicine practice for several diseases. Medical ozone rationale in COVID-19 is the possibility of contrasting endothelial dysfunction, modulating the immune response and acting as a virustatic agent. Thus, medical ozone could help to decrease lung inflammation, slow down viral growth, regulate lung circulation and oxygenation and prevent microvascular thrombosis. Ozone-therapy could be considered a feasible, cost-effective and easy to administer adjuvant therapy while waiting for the synthesis of a therapy or the development of the vaccine.

Keywords: COVID-19; SARS-COV-2; cytokine storm; endothelial dysfunction; immunomodulation; medical ozone; ozone; ozone therapy; virustatic.

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Conflict of interest statement

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Figures

Figure 1
Figure 1
Biological effects of oxygen-ozone. Note: LOP: Lipid peroxidation product; NO: nitric oxide; O3: ozone; ROS: reactive oxygen species. Adapted from Bocci et al.

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